Abstract 4144399: Impact of Protein-Calorie Malnutrition on Peri-procedural Outcomes of Transcatheter Aortic Valve Replacement: Latest Insights from National Database

Introduction: Transcatheter aortic valve replacement (TAVR) has emerged as an effective and less invasive percutaneous treatment option for select patients with severe aortic stenosis. Nutritional status plays a role in risk stratification for TAVR given its impact on peri-procedural outcomes. We aim to evaluate the impact of protein-calorie malnutrition (PCM) on the outcomes of TAVR. Methods: We queried the national inpatient sample database from year 2016 - 2020 to identify all patients who underwent TAVR. They were classified based on the presence of protein-calorie malnutrition. Statistical significance was assigned at p<05. Results: A total of 303310 patients underwent TAVR. 7430 patients among them had a diagnosis of PCM. Baseline demographics and comorbidities are presented in the table below. Patients with malnutrition had a higher prevalence of chronic lung disease, atrial fibrillation, chronic kidney disease, end-stage renal disease, and chronic liver disease were sicker at baseline as demonstrated by higher Charlson comorbidity index (53.51 vs 69.45, p-value: 0.001). With regards to in-hospital outcomes, the PCM group had a higher incidence of total major bleeding, post-operative deep venous thrombosis/pulmonary embolism, total vascular complications, and in-hospital mortality in patients with PCM as compared to those without. With regards to healthcare resource utilization, TAVR patients with PCM had a longer length of hospital stay and higher total charges. The multivariate analysis reveals that PCM is associated with higher in-hospital mortality (OR: 3.97 with 95% CI: 3.11-5.06). Conclusion: Protein calorie malnutrition is associated with worse outcomes with higher mortality, morbidity, and increased healthcare resource utilization in patients undergoing TAVR. Nutritional optimization should be considered when feasible in this challenging patient population. Studies are needed to understand the mechanisms for worse outcomes in the PCM group